Provider First Line Business Practice Location Address:
10 S 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16830-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-765-7577
Provider Business Practice Location Address Fax Number:
814-765-7606
Provider Enumeration Date:
10/28/2006